the

Anatomy of the Uterus | Ovaries | 3D Anatomy Tutorial

[Music]

hey I'm James and today I'm going to

discuss the uterus

I'll start by going over the structures

that make up the uterus

The Associated ligaments and related

viscera I will have move on to arterial

supply and venous drainage finally I

will discuss the relationship between

the blood supply and the ureter and its

implications for hysterectomy make sure

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the term uterus gets thrown around a lot

yet most are confused as to what

structures actually make up the uterus

the uterus consists of the uterine

corpus which is located here and most

distally do uterine cervix the uterine

corpus is described as having a fundus

located in a proximal region here and a

body located here some textbooks will

also describe an estimate portion

located here when the uterine cavity

narrows as it approaches the cervical

canal the cervix has two openings a

proximal opening here refer to as the

internals of course and a distal Oakland

which is the external South course which

allows for communication between the

uterine cavity the cervical canal and

the vagina which isn't included on this

model the uterus is described as having

three layers an inner endometrium which

lines two uterine cavity this is a

highly vascular glandular layer that is

subject to great changed for add the

menstrual cycle the myometrium is this

middle layer here it is primarily

muscular tissue with a small proportion

of fibrous tissue the outer layer is

named the peri me trium which is formed

by the overlying peritoneum however this

is not included in this model at the

moment the structure of the cervix

located here is slightly more

complicated and is not typically

described in anatomical texts it is

primarily a fibrous structure that acts

as a sphincter during pregnancy the

uterine tubes extend from the lateral

walls of the uterine corpus as we can

see here and here

they provide a connection between

Neutron corpus and the ovaries located

here and here although is important to

stress that there is no direct

connection between the ovary and uterine

tube instead fimbria located at the most

lateral ends of the uterine tube sweep

the ovum into the uterine tube the

female reproductive tract is therefore

open because there is a direct

connection between the outside world and

the female abdominal cavity this

provides two routes for the spread of

infection and a route for endometrial

tissue to reach the abdominal cavity as

there is no direct connection between

the ovary and uterine tube there is a

chance that our oven will not reach the

tube if fertilization occurs outside of

the tube it can result in an ectopic

abdominal pregnancy there are a number

of ligaments that's how associates with

the uterus your ovarian

ligaments which is located here and

around ligaments can be considered as

one continuous cord that runs from the

ovary so the corpus Tula labia majora

Loran Lichtman leaves the pelvic cavity

while a deep inguinal ring traverses

inguinal canal leaves through the

superficial inguinal ring and an

insertion to earth labia majora the

ovarian and man ligament are remnants of

the gubin a column which is the

embryonic cord like structure that

guides the cone attitude inguinal canal

normally the sense of the ganas will

only occur in males the other Lichtman

that can be considered at this point is

two broad ligaments the uterus is a sub

peritoneal structure similar to lots of

the bladder and a rectum and soul apart

Neum which we can see has been added

here and here draped over the uterus the

peritoneal matrix over the uterus forms

the parameter ium which is considered

the external layer of the uterus which

we can see here the peritoneum not

attached the uterus is too broad

ligaments the broad ligament can be

further subdivided in accordance with

the structures it is associated with so

at the moment we can see the past neom

here

and here can we refer to as the Mesa

ovarium and measure saplings

respectively because they're associated

with the ovary and need to run tube if

we rotate the model we can see the final

part of the broad ligaments which we can

refer to as the Mesa metrium which is

here so from this point on we are going

to consider the visceral and flush

relations of the uterus on the screen we

can see the uterus has been Hemi sect

heads and the Hemi sector bladder and

rectum have been added so if we rotate

the model around we can see that the

bladder is located anterior to the

uterus Ana rectum is located to the

posterior of the uterus the peritoneum

has once again been added to the model

and as you can see it drapes over the

pelvic viscera and so the pelvic viscera

can be described as submerged steel

structures here we can see the perineum

overlined the round ligaments of the

uterus and here the Platinum is over

line the ovarian neurovascular bundle

and consequently forming the suspensory

ligaments of the ovary pouches are also

forms between the pelvic viscera and

tearily between the bladder and uterus

we have the utero vesicle pouch the

space between uterus and the rectum

posterity here is known as the buter a

rectal pouch or sometimes referred to

her as the pouch of douglas these

pouches are within the personal cavity a

former space in which free fluid can

accumulate director utrom pouch located

here is the most inferior portion of the

peritoneal cavity and is often the first

place for free peritoneal fluid to

accumulate the collection of free fluids

can be a consequence of physiological or

pathological processes colder synthesis

is the process of draining this fluid

through the introduction of a spinal

needle through the vaginal wall through

the vaginal forces which you can see

here the furnaces are formed due to the

projection of the cervix which is here

into the vaginal cavity which forms a

continuous lateral recess around the

outside of the cervix and

war the relationship between the vagina

cervix and Neutron corpus are described

as a series of angles these angles are

relative to the long axis through the

center of these structures so as we

rotate the model we concede that the

cervix here projects into the vagina

here so we compared the long axes

through the vagina and through the

cervix it will create an angle of

anteversion similarly as we compare the

long axis through the cervix and the

uterine corpus it creates an angle of

anti flexion and this angle of anti

flexion allowing uterine corpus to

assume its natural position on the

superior surface of the bladder here

however the uterus can assume other

positions within the pelvis due to

alterations in the angles such as retro

version and retro flexion though these

variations rarely have clinical

implications various supporting

structures within the pelvis are thought

to assist in maintaining the angles of

anti version and anti flexion these

structures been the Cardinal ligaments

and each her sacral ligaments there is

little agreement with in the literature

about the attachment of these ligaments

though in general they are thought to be

connective tissue structures that

contain associated nerves and vessels

they extend from the cervix to the

sacrum in the case of the uterus sacral

ligaments and from the cervix to the

internal iliac vessels as in the case of

the Cardinal ligaments blood supply and

drainage at the pelvic viscera are from

branches of the internal iliac artery

and internal iliac vein which we can see

here however the ovary is slightly

different because the ovarian arteries

arise directly from the aorta these mini

ovarian arteries here and venous blood

is drains valley ovarian veins which on

the right hand side will drain into the

IVC and a left hand side will drain into

the left renal vein the uterine artery

arises directly from the internal iliac

artery the vagina artery which we can

see here was sometimes arise from

uterine artery

although in some cases it will arise

from the internal iliac artery at the

level of the cervix the uterine artery

will split to form the ascending branch

which will supply the corpus the uterine

tube and sometimes the ovary and a

descending branch which will supply it

to vagina however it is important to

remember that great variation is often

observed in this region of the body and

so it is important to trace the vessels

in order to ascertain which structures

they are supplying an important

relationship to remember is the position

of the uterine artery relative to that

of the ureter at the approximate level

of the issue spine the ureter will pass

inferior to that of detron vessels which

can be easily remembers using a phrase

water passes under the bridge the ureter

is in danger of being clamped ligated or

transected during hysterectomy

DHA is also vulnerable to injury during

an OVA or xme as your ovarian vessels by

very close to less of the ureter as they

cross over the pelvic brim so just a

quick summary the uterus is a collective

term referring to the uterine corpus and

cervix it is a sub peritoneal structure

as it lies inferior to the peritoneal

cavity pouches are located both anterior

and posterior to lead hrus within the

peritoneal cavity which allow for the

accumulation of free fluids the uterus

is supplied by the uterine artery which

is a branch of the internal iliac artery

Neutron artery is closely related to the

ureter and a level of the issue of

spines so it is important to remember

that the ureter passes inferior to the

artery during hysterectomy we'd love to

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